Closure plan not achievable – elementary sensitivity analysis by a member of the public
Posted: October 29th, 2009 | Author: DGPPG | Filed under: News | Tags: Alexander, BBC News, budget overspend, Corporate Policy Committee, debacle, not achievable, Proctor, sensitivity analysis, spreadsheet, £660000Comments: Leave your feedback, post a comment here »
The John Alexander/Judith Proctor Report (Appendix 1) dated 12-Oct was presented to the Social Work Committee on 20-Oct as the flagship ’savings proposal’ of that Department. It was the largest single ’saving’ of £660,000. It was then published on line to the media and everyone woke up in disbelief to the sudden, unexpected and unidentified ARC closures announcement by BBC Radio Scotland News at 07:00 & 08:00 being repeated again at 13:00 and 17:00. It was obvious to anyone with a grain of common sense that the proposal was nonsense and extremely damaging, given the highly cost effective contribution to D&G society made by the 6 ARCs. That such a plan had been cobbled together without any consultation or discussion with any of the managers of the six ARCs beggars belief. Whereas keeping the service users and their families wholly in the dark about a major change intended to be implemented only 5 months into the future is par for the course and a repeat of 2006. Bearing in mind some of the same managers were involved in the 2006 debacle, but since promoted, this is hardly surprising.
There was an inevitable outcry, as patronisingly anticipated and dismissed in the report because ‘change’ was involved, but seen as a risk to the Council’s reputation. Of course there was no assessment of risk to the service users and carers. But the plan was obviously not achievable, because no alternative activities existed, as has since been grudgingly admitted by Ms Proctor on 30-Nov when questioned about Newton Stewart. After various meetings of families and service users it was decided to produce a sensitivity analysis to demonstrate the reality rationally and numerically. At 01:03 on 29-Oct the summary analysis given as follows plus the underlying detailed Excel spreadsheet calculations were sent by email to the Chief Executive, with copies to John Alexander, other Social Wok managers, The Leader, Convener, Chair Social Work Committee, all Elected Members on the Corporate Policy Committee, interested families and the media. A day later all other Elected Members were sent a copy. After 5 weeks by 05-Dec no one has dissented from the arithmetic or assumptions and none of the questions have been answered. Just silence.
The Social Work Report Appendix 1 includes no real data. It is agreed there is no plan or blueprint. Sensitivity analysis shows the proposal is fallacious. The rational argument follows, with calculations in the attached Excel worksheet file. If you wish to receive a copy of the Excel file please email your request to help@dumfries-ghalloway.org.uk and you will be sent this.
Source of data: 2007 Mid Year Population Estimate D&G Council Information Briefing note No 17; The ‘Same as You’ Annual Survey 2007.
ARC staff in 6 centres (see Appendix 1) = 105 FTE. A ratio of 2.3:1 of clients to staff, on average
Total number of ARC clients = 244. Of these 118 attend 5 days per week – the full time cohort.
The mid 2007 population of D&G is 148,300. Of these adults (18 & over) = 117,548.
Thus ARC clients are ~0.2% of the adult population. There is no age limit on ARC clients.
The total D&G Council budget savings required are £6.5M
Of this the Learning Disabled (0.2%) are apparently required to contribute £0.66M or 10.2% via ARC closure.
Question 1: Discrimination. Do you accept that it is just and equitable that ~ 0.2% of the most vulnerable disabled in the adult population requiring the greatest care are expected to contribute 10.2% of the total D&G saving by losing their highly valued ARCs and degrading their quality of life? How will the selection of 4 centres be justified and has any possible legal challenge been considered, evaluated and costed as a downside risk?
We do not have the exact data for ARC clients who attend on: 1, 2, 3 or 4 days/week, despite this being requested.
Many attend for 4 days. Therefore we assume the average is 2.5 days per week for the part time cohort of 126 clients.
Calculation shows the total ARC client care hours per 48 week year = 282,360hrs at 100%.
But only 66% close in phase 1 so the initial ‘individual’ hours would be ~188,000 care hours
Hence the individual care cost with a £10/hr direct payment would be ~£2.8million for 100% and £1.88 Million at 66%
30 ARC care staff are sacked as 4 centres or 66.6% of buildings based capacity are closed in phase 1.
The proposal claims a saving of £660,000 or 23.4% of the £2.8million possible 100% consequential cost and 35% in phase 1.
The individual care cost at 66% is ~ £1.88M. Offset £0.66M saving = net cost increase of £1.22M
If the existing care is maintained as clearly stated but delivered ‘individually’ by “personalisation’ with direct payments or individual budgets there is no ‘saving’ but a cost of £1.22M
This is a measure of the basic downside overspend risk of this proposal, but no assessment of any other unintended consequences.
Question 2: Policy Intent: The proposal claims the service and quality of life will be improved or at least maintained. Hence can it be assumed there is no policy intent to cut care hours and degrade the service? If so the cost of closing 4 ARCs will be ~£1.2M as a minimum and require many more carers. This is a direct consequence of the existing buildings based economies of scale implicit in the present average client to staff ratio of 2.3:1.
Individual care will require a minimum of 1:1 or in severe complex needs cases a carer to client of > 1:1, possibly 2:1
At present all care plans are individual and personalised. Activities are varied and some do take place outside the ARC building, especially for the more able, who are assisted to be as independent as possible. The ARC has a training and development role that would be lost. One small but direct loss would be general and mental health nurse training run in conjunction with the local university & colleges. Has this loss been considered?
Question 3: Undisclosed policy intent: In reality is it actually intended and secretly planned to reduce the front line care and quality of life of this 0.21% of the population, our most vulnerable? If so, why has that not been disclosed and costed? To what level is it intended to reduce individual care hours?
Question 4: Needs & community availability: How can any savings be assumed when individual needs have not been assessed in terms of the non buildings based facilities that are available and whether it is possible or even desirable for clients to safely access and use these for up to 6.5 hours per day. How will transport be arranged?
How can any proposal be rationally and properly assessed if these data are not included in the Report and such questions, and many others answered? As there is much ignorance about the Learning Disabled and in some instances not a little fear of the unknown, we ask how any elected Member can decide on such a matter without personally visiting his/her nearest ARC and meeting their constituents and families and carers. If this is not done before the Corporate Policy Committee meeting on Tuesday 03-Nov, for those involved, how can you realistically know what you are deciding upon.
Because this proposal is so flawed and is causing such distress to the most vulnerable you are urged to remove it from any further consideration at the Committee meeting next Tuesday Nov 3rd. This is not a ‘savings’ option but a real risk of budget overspend and other negative results. Its continued inclusion is highly damaging.
Until this proposal is fully reworked in detail, with full front line user and carer involvement, to which the Council is committed as a policy and thus invests resources, it should be deleted from the list forthwith. It is not a credible ‘option’. UCI (User and Carer Involvement) has been created to facilitate such work and Morven Cambell is invited to circulate her views on this to you all, as a matter of great urgency. Note that despite requests she did not do so begging another question about the 50% Council funding cost of UCI and its real ‘independence’. Pipers and tunes spring to mind.
Elected Members were asked to consider their moral imperative, if not a duty, to protect the vulnerable and their family carers, some of whom are pensioners in their 80s and 90s.
On Tuesday please will you so act and vote out this flawed ‘option’, removing such damaging ongoing uncertainty.
A footnote to UCI read: Morven. Please will you briefly explain to the Members from a UCI perspective why user and carer involvement at the outset in preparing any proposal like this is essential, and without it the present wholly negative situation of confusion, conflict and consternation is the inevitable result. Thank you. She did not do so.
There has ben no answer to the question of why a member of the public has to work through the night to mine for the data and produce an analysis that we pay Council managers and accountants to do.
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